European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
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Eur J Cardiothorac Surg · Jun 2012
A dose-response study of levosimendan in a porcine model of acute ischaemic heart failure.
Levosimendan is a novel inotropic agent claimed to improve myocardial contractility by a calcium-sensitizing effect. Our aim was to evaluate dose-dependent effects of levosimendan on left ventricular (LV) contractility and energetic properties in an acute, ischaemic heart failure porcine model. ⋯ Surprisingly, levosimendan had no significant effect on contractility, energy efficiency and mitochondrial respiration of the LV, in a porcine model of acute heart failure. At high doses, levosimendan induced vasodilatation and increased heart rate and cardiac output.
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Eur J Cardiothorac Surg · Jun 2012
Multicenter StudyCarcinoid heart disease: outcomes after surgical valve replacement.
To describe the early and late outcomes of carcinoid patients undergoing surgical heart valve replacement. ⋯ Despite advanced cardiac morbidity at the time of operation, early postoperative survival was 90%. Long-term survival of patients with carcinoid heart disease undergoing valve replacement is determined by carcinoid progression. The surviving patients had a persistent improvement in functional capacity without valve-related complications of the mechanical prosthesis.
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Eur J Cardiothorac Surg · Jun 2012
Renal impairment and transapical aortic valve implantation: impact of contrast medium dose on kidney function and survival.
Patients undergoing transapical aortic valve implantation (TA-AVI) are usually over 80 years old and have a high prevalence of chronic kidney disease. However, transcatheter valve therapies require the use of contrast injections with the risk of nephrotoxicity. The aim of this study was to evaluate post-operative kidney function and survival in patients with pre-existing renal impairment with regard to the amount of contrast media used during TA-AVI. ⋯ Our results indicate a possible association between higher CIN and mortality rate and the extensive use of contrast media during TA-AVI among high-risk patients with pre-existing renal impairment.
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Eur J Cardiothorac Surg · Jun 2012
Ventricular assist device implantation in patients on percutaneous extracorporeal life support without switching to conventional cardiopulmonary bypass system.
Ventricular assist device (VAD) implantation using cardiopulmonary bypass (CPB) is an established procedure. However, the well-described complications of CPB may exacerbate multiple organ failure and increase blood product transfusions especially in end-stage heart failure patients. ⋯ Our experience suggests that VAD implantation using percutaneous ECLS without switching to conventional CPB is a safe alternative in the bridge to bridge concept, especially in high-risk patients with cardiogenic shock who would benefit from the avoidance of the adverse sequels associated with conventional CPB.
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Eur J Cardiothorac Surg · Jun 2012
Does listing for heart transplant for longer than 30 days before ventricular assist device implantation influence utilization of psychotherapeutic support and outcome?
Previous studies indicate that patients with mechanical ventricular assist devices (VADs) experience high psychosocial and emotional distress. Listing for transplant may trigger psychosocial adjustment to the transplantation as an upcoming critical life-event. We hypothesized that patients could profit from this adaptation when implantation of a VAD becomes necessary. ⋯ Our data indicate that listing for HTX for >30 days before VAD implantation does not reduce the utilization of psychotherapeutic support by VAD patients. We assume that structured emotional and psychosocial support by the interdisciplinary VAD team, including professional supportive psychotherapy, is indispensable for successful coping of VAD patients and their families.